Application of 3D-Printed Personalized Guide for Lateral Femoral Positioning in Anterior Cruciate Ligament Reconstruction of the Knee.

Objective: This research aims to investigate the effectiveness of 3D computer-assisted customized guided positioning of the lateral femoral tunnel compared to conventional methods for Anterior Cruciate Ligament (ACL) reconstruction surgery. Methods: A total of 80 patients with a complete ACL tear who underwent arthroscopic reconstruction with autologous tendon transplantation (semitendinosus-gracilis tendon) were included in this study. The patients were admitted to our hospital between March 2020 and January 2022 and were randomly divided into two groups: the conventional group (n = 40) and the personalized guide group (n = 40), based on the positioning method. The conventional group underwent ACL restoration using standard surgical techniques, while the personalized guide group opted for the more precise computer-assisted personalized guide method. The lateral femoral tunnel times were compared between both groups. Additionally, the International Knee Documentation Committee (IKDC) and Lysholm scores were assessed, and the lateral femoral location was evaluated using X-ray imaging at 2 weeks postoperatively. Results: After surgery, both groups showed a statistically significant increase (P < .05) in Lysholm and IKDC scores compared to their pre-surgery scores. However, the two groups had no evident difference (P > .05). X-ray evaluation at 2 weeks post-surgery revealed no significant difference between the two groups in NL/ML, AL/BL, α, and ß angles (P > .05). The preparation time for the femoral tunnel was significantly shorter in the personalized guide group (6.18 ± 0.92 min) compared to the traditional group (15.94 ± 3.12 min) (P < .05). Conclusions: The computer-assisted 3D personalized guide positioning method is more effective in locating the lateral femoral tunnel for ACL reconstruction of the knee and can substantially reduce the positioning time. This study provides valuable insights for clinicians when selecting surgical methods.

miR-137 targets the inhibition of TCF4 to reverse the progression of osteoarthritis through the AMPK/NF-κB signaling pathway.

PURPOSE: To explore the regulatory mechanism of miR-137 and transcription factor 4 (TCF4) in the progression of osteoarthritis (OA). PATIENTS AND METHODS: The expressions of miR-137 and TCF4 were detected in OA cartilage tissue, chondrocytes and OA rat cartilage tissue. miR-137 and TCF4 were up-regulated or down-regulated and transfected into chondrocytes and OA rat cartilage tissue. The gene expression, protein level, cell proliferation, apoptosis and inflammatory factors were detected, respectively. LPS and anterior cruciate ligament transection (ACLT) on the right knee were used to induce chondrocyte inflammation and establish rat OA model, respectively. RESULTS: miR-137 was low expressed in cartilage tissue of OA group, while TCF4 expression and protein level were significantly higher, showing significant negative correlation. In LPS group, chondrocyte activity was significantly inhibited, cell apoptosis ability was significantly enhanced, and the levels of inflammatory factors TNF-α, IL-1ß, IL-6 were significantly increased. However, the above results were significantly improved after the up-regulation of miR-137 or down-regulation of TCF4. Double luciferase report revealed that miR-137 and TCF4 had targeted relationship. LPS induced activation of AMPK/NF-κB pathway and higher level of apoptosis. AMPK/NF-κB pathway inhibitor C could inhibit activation of this pathway, and up-regulation of miR-137 or down-regulation of TCF4 could significantly weaken the regulation of LPS on the pathway and apoptosis. Analysis of OA rat model showed that over-expression of miR-137 could inhibit up-regulation of inflammatory factors and activation of AMPK/NF-κB pathway. CONCLUSION: miR-137 targets the inhibition of TCF4 to reverse the progression of OA through the AMPK/NF-κB signaling pathway.

MiRNA-199a-5p Protects Against Cerebral Ischemic Injury by Down-Regulating DDR1 in Rats.

OBJECTIVE: To assess the effects of miR-199a-5p on cerebral ischemic injury and its underlying mechanisms. METHODS: Infarct volume, neurologic deficit scores, and brain water content were evaluated after 24 hours of reperfusion. The histopathological damage in cortical neurons was assayed by hematoxylin and eosin staining. Neuronal apoptosis was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. The regulatory effect of miR-199a-5p on discoidin domain receptor 1 (DDR1) was investigated using a dual luciferase reporter gene assay. Expression levels of miR-199a-5p and DDR1 were detected by real-time fluorogenic polymerase chain reaction and Western blot analysis. Expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-ß, and IL-6 were investigated by enzyme-linked immunosorbent assay. RESULTS: Our results suggest that DDR1 is the target gene of miR-199a-5p. The expression levels of miR-199a-5p and DDR1 were significantly down-regulated and up-regulated in the rats with cerebral ischemia compared with the control and sham groups, respectively. Moreover, infarct volume, neurologic score, brain water content, neuronal damage, and neuronal apoptosis were significantly decreased in the mimics group, siRNA DDR1 (siDDR1) group, and especially the mimics + siDDR1 group. The results also confirmed significantly weakened expression levels of proinflammatory cytokines (TNF-α, IL-6, and IL-1ß) in mimics, siDDR1, and especially mimics + siDDR1 rats. In addition, DDR1 silencing attenuated the effects of the miR-199a-5p inhibitor on neurologic function, infarct volume, brain water content, and proinflammatory cytokine expressions after middle cerebral artery occlusion in rats. CONCLUSIONS: miR-199a-5p may protect against cerebral ischemic injury by down-regulating DDR1 in rats.

Three-dimensional printing in the preoperative planning of thoracoscopic pulmonary segmentectomy.

BACKGROUND: The purpose of this study is to explore whether 3D printing has a better clinical value for making a preoperative plan than three-dimensional computed tomography (3D-CT) in thoracoscopic pulmonary segmentectomy. METHODS: We collected a total of 124 patients' clinical data who underwent thoracoscopic pulmonary segmentectomy from October 2017 to August 2018. According to the preoperative examination, the patients were divided into three groups: general group, 3D-CT group, and 3D printing group. The clinical data of each group were analyzed and compared. RESULTS: Compared with the general group, intraoperative blood loss in 3D-CT group and 3D printing group decreased significantly (P<0.05). Operation time in 3D-CT group and 3D printing group was significantly shorter than in the general group (P<0.05). Between 3D-CT group and 3D printing group intraoperative blood loss and operation time had no significant differences (P>0.05). Postoperative chest tube duration and postoperative hospital stay had no significant differences between each group P>0.05). The incidence of postoperative hemoptysis in the general group occurred higher than in the 3D-CT group and 3D printing group, but the differences were not statistically significant (P>0.05). Postoperative complications of pneumonia, atelectasis, and pulmonary air leakage (>6 d) had no significant differences between each group (P>0.05). CONCLUSIONS: 3D printing and 3D-CT for making a preoperative plan have an equivalent effect in thoracoscopic pulmonary segmentectomy for experienced surgeons. Preoperative simulations using 3D printing for the assessment of pulmonary vessel and bronchi branching patterns is beneficial for the safe and efficient performance of thoracoscopic pulmonary segmentectomy.